OP0150 ASAS RECOMMENDATIONS FOR REQUESTING AND REPORTING IMAGING EXAMINATIONS IN PATIENTS WITH SUSPECTED AXIAL SPONDYLOARTHRITIS
Authors: T. Diekhoff, I. Eshed, C. Giraudo, K. G. Hermann, M. De Hooge, L. Jans, A. G. Jurik, R. G. Lambert, P. M. Machado, W. P. Maksymowych, M. Mallinson, H. Marzo-Ortega, V. Navarro-Compán, S. Juhl Pedersen, M. Østergaard, M. Reijnierse, M. Rudwaleit, F. Sommerfleck, U. Weber, X. Baraliakos, D. Poddubnyy
Journal: Annals of the Rheumatic Diseases (2022)

Background Clinicians face uncertainties in their daily practice when requesting imaging examinations for patients with suspected axial spondyloarthritis (axSpA) or when producing an imaging report because the requirements and desired information of radiologists and rheumatologists / orthopedics alike are sometimes not completely known or understood. Objectives This project aimed to develop practical consensus recommendations for the standardized communication around imaging of sacroiliac joints and spine for diagnostic purposes in patients with suspected axSpA or their management in clinical practice. Methods An international task force was established combining radiologists (n=7) and rheumatologists (n=13) from the Assessment of SpondyloArthritis international Society (ASAS), two members of Young ASAS and a patient representative. The task force defined the project’s aims and developed a project statement. Then, considering published literature and the work of other groups, two survey rounds were designed, and all ASAS members invited to respond: first, to identify items for further consideration, second, to consider the detail of information to be communicated. Finally, ASAS members discussed the recommendations proposed by the task force during the ASAS annual workshop in January 2022 and voted regarding endorsement of the recommendations. Results The final set of recommendations is presented in Figure 1. Six recommendations deal with imaging requests in patients with axSpA. The first three recommendations entail clinical features, patients’ symptoms and risk factors. Recommendation 4 concerns previous imaging and reports and recommendation 5 refers to contraindications to imaging or contrast media. Recommendation 6 is about the suspected diagnosis and possible clinical differential diagnoses and the reason for the examination. Eleven additional recommendations refer to the radiology report. The first point addresses clinical information included in the report. Recommendations 2 to 4 advise on information about the technical conduct of the exam, the use of contrast media and image quality. Imaging findings that should be mentioned in the report if present are listed in recommendations 5 to 7. Finally, recommendations 8 to 11 combine advice for the conclusion, and for suggesting additional imaging or referral to a rheumatology expert if a different physician requested the imaging. The recommendations were endorsed by ASAS with approval from 73% of voting members (43 agreed, 10 rejected, 6 abstained). Figure 1. ASAS recommendations for requesting and reporting imaging in patients with suspected axial Spondyloarthritis. Conclusion These ASAS recommendations provide guidance for requesting and reporting imaging examinations in the context of axSpA and for standardizing and enhancing communication between rheumatologists and radiologists to improve diagnosis and patient care. Disclosure of Interests Torsten Diekhoff Paid instructor for: Novarits, Eli Lilly, MSD, Canon MS, Consultant of: Eli Lilly, Iris Eshed: None declared, Chiara Giraudo: None declared, Kay-Geert Hermann: None declared, Manouk de Hooge: None declared, Lennart Jans: None declared, Anne Grethe Jurik: None declared, Robert G Lambert: None declared, Pedro M Machado: None declared, Walter P Maksymowych: None declared, Michael Mallinson: None declared, Helena Marzo-Ortega: None declared, Victoria Navarro-Compán: None declared, Susanne Juhl Pedersen: None declared, Mikkel Østergaard: None declared, Monique Reijnierse: None declared, Martin Rudwaleit: None declared, Fernando Sommerfleck: None declared, Ulrich Weber: None declared, Xenofon Baraliakos: None declared, Denis Poddubnyy: None declared